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[Cholestasis after antiarrhythmic therapy with propafenone]
Deutsche Medizinische Wochenschrift (1946)
|October 5, 1984
Summary
Propafenone caused intrahepatic biliary stasis, a potential drug-allergic hepatitis, in an elderly patient with ventricular extrasystoles. In vitro tests confirmed propafenone-sensitive lymphocytes, supporting a drug-induced reaction.
Area of Science:
- Pharmacology
- Hepatology
- Immunology
Background:
- Ventricular extrasystoles are common arrhythmias.
- Propafenone is an antiarrhythmic medication.
- Drug-induced liver injury (DILI) presents a diagnostic challenge.
Observation:
- An 84-year-old male with ventricular extrasystoles (Lown IVa) received propafenone (150 mg TID) for 33 days, and again two years later for 6 days.
- Both instances of propafenone administration resulted in intrahepatic biliary stasis.
- Other potential causes for the observed condition were systematically excluded.
Findings:
- The intrahepatic biliary stasis was presumed to be a manifestation of drug-allergic hepatitis.
- Lymphocyte transformation tests revealed in vitro sensitivity to propafenone in the patient's lymphocytes.
- This suggests a specific immune response to propafenone.
Implications:
- Propafenone can induce immune-mediated liver injury, specifically intrahepatic biliary stasis.
- The lymphocyte transformation test is a valuable tool for diagnosing drug-induced hypersensitivity.
- Clinicians should consider propafenone as a potential cause of hepatitis in patients presenting with biliary stasis.